OrganizationPrimerodentalDentistDental ProvidersPractice AddressMision De San Javier #10709-3, Tijuana, Baja California 22010 (Mexico)(619) 565-1077PECOS EnrollmentBased on the most recent information from CMS, provider Primerodental does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1851126528Provider TypeOrganizationFull NamePrimerodentalSubpartNoEnumeration Date9/3/2024Last Updated9/3/2024Contact InformationPractice LocationPractice AddressMision De San Javier #10709-3, Tijuana, Baja California 22010 (Mexico)Phone(619) 565-1077Fax(866) 864-5572Mailing LocationMailing Address4370 Palm Ave # D-637, San Diego, CA 92154-1760Phone(619) 565-1077Fax(866) 864-5572Authorized OfficialNameToraya, Luis Antonio (Partner Mgr.)Phone(619) 565-1077Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicenseUnlisted Issuer